NPIMap

Organization Active NPI

Standup Polk

  • Community/Behavioral Health Agency
  • Lakeland, FL
National Provider Identifier
1710325998
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STANDUP POLK
Practice address
621 S Florida Ave
Lakeland, FL 33801-5230
Phone
(863) 802-0777
Fax
(863) 802-0065
NPI assigned
Jun 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angela Ellison
Title
Executive Director
Phone
(863) 802-0777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

621 S Florida Ave
Lakeland, FL 33801-5230

Mailing address

621 S Florida Ave
Lakeland, FL 33801-5230
Phone (863) 802-0777

National Provider Directory

National Provider Directory
Tax ID family
Drug Prevention Resource Center Dba Inneract Alliance3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1710325998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015230",
            "telephone_number": "863-802-0777",
            "fax_number": "863-802-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015230",
            "telephone_number": "863-802-0777",
            "fax_number": "863-802-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANDUP POLK",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "863-802-0777"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.